Comments on: Healthcare Update — 03-10-2010http://www.epmonthly.com/whitecoat/2010/03/healthcare-update-03-10-2010/
A blog from inside the emergency departmentSun, 26 Jul 2015 17:57:28 +0000hourly1http://wordpress.org/?v=4.2.3By: VA Hopefulhttp://www.epmonthly.com/whitecoat/2010/03/healthcare-update-03-10-2010/#comment-18157
Fri, 19 Mar 2010 12:58:03 +0000http://www.epmonthly.com/whitecoat/?p=4504#comment-18157I did not know that. Makes me feel some better about the whole mess.
]]>By: Matthttp://www.epmonthly.com/whitecoat/2010/03/healthcare-update-03-10-2010/#comment-18149
Fri, 19 Mar 2010 02:57:36 +0000http://www.epmonthly.com/whitecoat/?p=4504#comment-18149Good point. Can you give me a more specific example of a case you’re thinking of?
]]>By: Matthttp://www.epmonthly.com/whitecoat/2010/03/healthcare-update-03-10-2010/#comment-18148
Fri, 19 Mar 2010 02:56:50 +0000http://www.epmonthly.com/whitecoat/?p=4504#comment-18148Well, for the most part, those outlier awards are never paid. They’re typically settled or reduced on appeal, or knocked down on remittur. There are safeguards even after verdict, you know.
]]>By: VA Hopefulhttp://www.epmonthly.com/whitecoat/2010/03/healthcare-update-03-10-2010/#comment-18139
Thu, 18 Mar 2010 18:28:39 +0000http://www.epmonthly.com/whitecoat/?p=4504#comment-18139You make some good points, and I guess I’m just for something that would both decrease the absurd awards and find something for people who are injured but nothing really comes of it.
]]>By: VA Hopefulhttp://www.epmonthly.com/whitecoat/2010/03/healthcare-update-03-10-2010/#comment-18138
Thu, 18 Mar 2010 18:20:20 +0000http://www.epmonthly.com/whitecoat/?p=4504#comment-18138I think you might be missing my point. Let me try to clarify. You have two treatment options that have research showing that both are good choices. You go with one and the patient is injured. You followed the literature and half of medicine thinks you did the right thing. The prosecution talks to the other 50% that thinks you screwed up. They have good research on their side too. How is the legal system supposed to solve this problem when the people who actually know what’s going on can’t come to a consensus?
]]>By: Matthttp://www.epmonthly.com/whitecoat/2010/03/healthcare-update-03-10-2010/#comment-18125
Thu, 18 Mar 2010 15:44:32 +0000http://www.epmonthly.com/whitecoat/?p=4504#comment-18125“Don’t you see the inherent problem here? Both ways might have good evidence for doing them, but at the same time you can get others swearing that one way is quackery.”

I don’t see that as a problem, I see that as the need for the dispute resolution system.

“Second, I would be very curious to see some of the cases that med mal folks (I’ll try to be specific from here on) turn down.”

You’d probably never see them unless the client released the paperwork to you, because of attorney client privilege. The attorney can’t.

“Your third point is similar enough to the first that I don’t think it bears rehashing.”

The third point isn’t similar at all. It goes to the law firm economics, not the necessity of a physician being involved. Simply put, taking a bunch of questionable med mal cases is bad business because of the cost to pursue them.

]]>By: Matthttp://www.epmonthly.com/whitecoat/2010/03/healthcare-update-03-10-2010/#comment-18124
Thu, 18 Mar 2010 15:38:42 +0000http://www.epmonthly.com/whitecoat/?p=4504#comment-18124” Most of the data suggests that these injuries are unavoidable and happen in utero, however, sympathetic juries have been known to be swayed by the sight of a substantially injured baby in the courtroom and a charismatic plaintiff’s attorney.”

This seems to me to be quite an assumption on your part, as you don’t know the jury, the evidence, or really any of the details of the cases you reference. Or have you read the trial transcripts?

Physicians seem to believe that jurors are all weak minded sob sisters waiting to be misled by plaintiff’s lawyers while the defense sits there like a potted plant. Yet somehow physicians win far more often at trial than they lose, even sometimes in the face of devastating injuries.

You’re right in most cases it’s unlikely to be caused by the OB-GYN’s actions. But I doubt you would say it is NEVER caused by the physician’s actions, would you? And since we don’t know the ratio of brain injury children to brain injury cases, it’s entirely possible that there are far fewer lawsuits on those cases than you’d expect. You just don’t hear about the ones that aren’t filed.

Unless you’ve got more data, I’m not sure how you can conclude that my statement isn’t borne out by the facts.

]]>By: Matthttp://www.epmonthly.com/whitecoat/2010/03/healthcare-update-03-10-2010/#comment-18123
Thu, 18 Mar 2010 15:34:38 +0000http://www.epmonthly.com/whitecoat/?p=4504#comment-18123That is an interesting question. Although I think perhaps we can look at it a different way. Should it be worth nothing? You’re absolutely right money can’t make you forget, but simply because money is an imperfect medium, should we throw it out altogether.

As to your idea of a schedule, if we can decide that it is worth something, I don’t believe a schedule is fairness. Is the same injury to an athlete in their prime as valuable to a 75 year old at the end of their life expectancy who is largely immobile? I think not.

This is why we have a jury, I believe. To take twelve members of society and let them make an assessment based on the facts. I don’t view a schedule promulgated by lobbyists is a better solution. Will there be verdicts on the high end? Of course. At the same time, there will be verdicts on the low end, although physicians don’t usually want to talk about those. There will be no truly perfect system where all of society says ah, yes, that’s the perfect number. There will always be someone who disagrees with the jury’s finding. Or for that matter a legislative schedule. But I would favor letting the facts of the case dictate the value, rather than whatever pressure lobbyists can bring to bear regardless of the facts.

First, you’ve proved my point for me. There are areas in medicine where people disagree. There can be good evidence for 2 different ways of doing this and thus you’ll have doctors who are willing to say “Nope, that other way is pure garbage and should never be done ever”. Don’t you see the inherent problem here? Both ways might have good evidence for doing them, but at the same time you can get others swearing that one way is quackery. Now, part of that is admittedly the huge egos that abound in medicine. But then again, part of that is inherent in what we do.

Second, I would be very curious to see some of the cases that med mal folks (I’ll try to be specific from here on) turn down.

Your third point is similar enough to the first that I don’t think it bears rehashing.

]]>By: VA Hopefulhttp://www.epmonthly.com/whitecoat/2010/03/healthcare-update-03-10-2010/#comment-18116
Thu, 18 Mar 2010 12:58:16 +0000http://www.epmonthly.com/whitecoat/?p=4504#comment-18116Here is where we reach an interesting point. How do you decide what a particular injury is worth? Taking that further, is there any amount of money that can make a person forget about the injury and be able to live a normal life?

I recently read about the case in NYC where a woman won $60 million because a plastic surgeon screwed up and now her labia looks strange. How on Earth is that a reasonable pain and suffering settlement?

It sounds like we need a list of injuries and appropriate non-economic damages. A doctor does this, you get this much. I doctor does that, you get that much.